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Collection: Original Records > Death Records
Mortuary Records 1940-06 to 1943-05 - Index Included (324 pages)

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Page: of 324

RECORD OF FUNERAL
° 4
Total No.. 7 § pate LL a7 pe the dlstece: aie ou
SAE DMEM. OYE ee Se ea ag a ee
(CJ8usband[_Wifel_]Widow t
Sess ae gil ae arene eae or
Complete Funeral......-.2.2+-eeeee> $i.. REA
Ph ne wedi Burial vase or Box... see peek rch bral Fagen sens
How Secured. ... A FTI ML ccc cece cence Embalming Body tees ph = Embalmes) bE ata . (Sine Tr SL So
Occupation.....0..So a ain ceehacanantee aan er cat Barber, $..... . Hair Dressing, $....]]....
(Social Security Number) . Dressing Body, $..... Underwear,$...]}....
Name of Employer.. . 2.0.27.. e sees sere eee eee ences OE oo EI en ene lai iat
(State Kind and Color)
PRQOTCRS Ge «regis bare Ke dhe II alo aes: bealbc bP suelitere ab Ensure Slippers, $ cet . A, Saini 5 OBC ee ol isrsdivare as Ra areas
Date of Death lat. . keen 5 3) ene Folding Chairs, $.... Tarpaulin,$..... ....
re (Date) (Hour) . Candelabrum, $.... Candles, $25.0.. dc ffe.s oun
PROTO CE TOI ia sind 60's ony she's oS diy Hed wns b 4 00 shee deine Hos Door Spray, $..... GlOVEE Be 6 vic ens RECS ee Ok
a Funeral Car, $ /3. ~..Ambulance, $..... . .. 43
ae a (Wears) TE Months) "7°" Ways) Limousines to Cemetery... eS. Ee ey etal
Date of Funerak/7ar. /7. Alsctrtedey ee: Ce &o .m. Autos to R. R. Station. ... 9 sis orcs ens es
(Date) e i ; eo? Getting Fengins PORE. oi. vin eet eee oes eet evea ss
Services at PA. wee EWA priate Coes 6 eo al.e 6 GLb eres Semel’ ©. 6 bi ehelay alee a9 3 Takin Remains i) hcl oe a ae ree OE UUM ead e
g
Clergyman. WA. , Aaah. ee, sc Ree bs Trip to Coroner’s Inquest ....-.--++-+0ff..
Es. (Address) Delivering Bot tO. 6.5 eke ta scenesecsceedelle cassis
Religion of bs eH . WA beeen teen este ee ee eee eees Deliver Flowers t0.....ccceceeceeccescecll oc cee,
irthnl Mana. ps ONG. Saale = MLEIMOVAl CHARON. 1G os > Guise soa pel ive asec lees wis
5 ; . cp 7 ' Procuring Burial Permit. es a eta
Reetceat ie a Caicehy ‘'Gesde’ “tated . 2 Cartit. Coptecat Death CertieateNo ol.. 2.
Pe i : . (State Physician’s or Coroner's )
Place of Death 2. ¢ pee Pall Bearer Service, $.. Use of Chapel, $... . .. i
Cause of Death. <r yy Personal Service..... sel co epacere de
Contributory Causes. LIL) fr ETE ee ah es . Ce
aR at erate rhs iyi: aie ee . Gross Total for Sales Tax.......... Bhi ib eee
a. mel CNRS SOR AN sian pisos ying o-4 ss a + cy detec pree oo ms
' Certifying Physician. . Cremation
' aaa ation.... ee reer Cerrar
ity AAdvewns A oe, Lh hehe. 172) LA ngshe. __. .---line Death Notices in... Papers 5.. eee coca es
c 2 ok art Susoale Si ae Shins Secu tiiceepay cities
Name of Father. sg PE be edn Flowers, $.. -Palms, oo 7 Matting be 3. TOME Se
His Birthplace.... 0 WAS oe Tae cig sate Rental of Tent, $..of Temporary Vault,$... }. . im ob
; fOpening of Grave or Temb. RV UP.. pe 5
: Maiden Name of Mother. ie 4 yi Lining Grave, $... Lowering Device, $... . ....
Her Birthplace...... f of. m3 Outlay for Shipping Charges. ........])... "
= Merete : , Clergyman, $J'°>. .Singers,$..Organist,$... . ...9.
Shi to. AMARA.. C1. Ahh. eee eee. ; ?
Ship Remains : sth Ratroad \aickets,$.... Plage Service,$... )....
Size Of Casket oS sc 5 ook eee kel Sis x Slee oe wc dated Telegr., Phone, Cable or Radio Charges oi), eee es
Manufactured by.. oi. 65 sis 5s cs cenacsecies etre ASUNES OVINE p's dey ves wud eS ka de walle a otalernlh
Bae Out of to ertaker’s Charges....... . ..-Ee es ee eee eae 6 ata er ee
Po ORE aces ie Rae Sel
‘ Total Footing of Bill........000005. $I. S. 6.
1 Pe ne Ela ells Ea ae iste, dieretal sl gueeagens Sans (outta s $ eRe
. CRESS ae Balance....... Sikes wena’.
"Diagram of Lotor Vault. Entered into Ledger, page... or below.